Does Medicaid Cover Walkers? | Qualifying For A Walker
- Does Medicaid cover walkers? Learn more about the Medicaid rules surrounding walkers and other durable medical equipment and qualifying for medical equipment.
Walkers are a popular aid among seniors because they help people stay mobile and reduce the risk of falls. This increases independence, allowing older adults to move around their home and community with greater ease. Given the advantages, it’s unsurprising that their use continues to grow. For seniors interested in experiencing the benefits, the most important question may be whether Medicaid covers walkers.
Does Medicaid Cover Walkers?
There isn’t a single set of rules for Medicaid. The program is jointly funded by federal and state governments, and it’s state governments who administer Medicaid. Each state has a different set of rules, and most states have a number of subprograms that also have different requirements and benefits.
This means it’s difficult to say without qualification that Medicaid covers walkers. However, in most states durable medical equipment (DME), including walkers, is included among Medicaid’s benefits for people who meet the eligibility requirements.
How Do You Qualify for a Walker?
To qualify for a walker through Medicaid, it must be medically necessary. In Medicaid’s words, it must be “needed to diagnose or treat an illness, injury, condition, disease or its symptoms.” In practical terms, this means that the walker must be prescribed by your health care provider.
To actually receive your walker, you'll need to follow your state's procedures. If you’re in a nursing home, the staff should take care of everything. However, if you’re living in the community and enrolled in a home and community-based services (HCBS) waiver, you’re required to take a few more steps, which normally include:
- Getting a medical justification letter from your doctor or therapist
- Finding a Medicaid-approved supplier and provide them with the letter
- The supplier completing a prior approval application and sending it to Medicaid for approval
- The Medicaid office approving or denying the request and letting you and the supplier know of its decision
If your request is approved, the supplier will give you your walker and the bill is sent directly to Medicaid. If your request is denied, Medicaid will let you know why and give you details on how to appeal the decision.
What Equipment Does Medicaid Pay For?
Medicaid covers a range of durable medical equipment; however, the exact definition and list of covered equipment can vary from state to state. Most states define durable medical equipment as “equipment that can withstand repeated use, is primarily used to serve a medical purpose, is appropriate for home use and is not useful to a person without illness or injury.” In addition to walkers, equipment generally covered includes wheelchairs, hospital beds and home oxygen equipment.
In every state, Medicaid will only cover medically necessary equipment, which must be prescribed by a health care professional. Equipment covered by Medicaid must also be cost effective. In practice, this means that DME provided by Medicaid is normally a basic model.
If the equipment you need isn’t covered by Medicaid, there are other options for obtaining walkers and other DME. You can buy equipment yourself. Many people find that buying from an internet store is a more affordable option. Some states also have DME programs that have loan closets where you can borrow equipment or refurbished equipment available at reasonable prices. There are also charities in many areas with similar programs.
Lastly, Medicare Part B may also cover part of the cost of DME. In most cases, Medicare covers 80% of costs; however, the process is often similar to Medicaid with similar eligibility requirements. Medicare Advantage must provide the same cover as Original Medicare, but specific costs depend on the plan you’re enrolled in.